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Problem solving in clinical practice
Problem-solving in clinical practice: Persisting respiratory distress in a premature infant
  1. Daniel R Owens1,2,
  2. Clarissa Michelle Medalla3,
  3. Kelly N Brown4,
  4. Kishani Wijewardena3,
  5. Claire P Thomas5,
  6. Mildred A Iro2,6,
  7. Christine E Jones1,2,
  8. Saul N Faust1,2,
  9. Sanjay Valabh Patel6
  1. 1 NIHR Southampton Clinical Research Facility and NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2 Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
  3. 3 Department of Child Health, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK
  4. 4 Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  5. 5 Department of Clinical Microbiology/Infection, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK
  6. 6 Paediatric Infectious Diseases and Immunology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Sanjay Valabh Patel, Paediatric Infectious Diseases and Immunology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; sanjay.patel{at}uhs.nhs.uk

Abstract

The deterioration of a previously stable preterm infant is a common scenario on the neonatal unit. The the most common bacterial causes of deterioration are nosocomial infections, such as coagulase-negative Staphylococcus and Staphylococcus aureus. Non-infective conditions such as pulmonary haemorrhage, anaemia of prematurity and necrotising enterocolitis may also cause preterm infants to deteriorate. This case chronicles the unusual diagnostic journey of an infant born at 27+1 weeks who deteriorated at 26 days of life and did not respond to antimicrobial therapy as anticipated.

  • infectious diseases
  • neonatology

Data availability statement

There are no data in this work

https://doi.org/10.1136/archdischild-2019-317757

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    Data availability statement

    There are no data in this work

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    Footnotes

    • Contributors DRO performed the literature review and wrote the article. CMM provided details of the case report. CPT and KNB contributed portions of the article. KW, CEJ, SNF and SVP clinically managed the patient and provided comments on the manuscript. SVP acts as guarantor of the content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.